Medicaid Financial and MES implementation Technical Lead

Agency

Dept of Health and Human Services

Division

SEC OFFICE - INFO TECH

Job Classification Title

Applications Systems Specialist I (NS)

Position Number

60037865

Grade

• DT10
• About Us

The North Carolina Department of Health and Human Services (DHHS) is one of the largest, most complex agencies in the state, and has approximately 17,000 employees. It is responsible for ensuring the health, safety, and well-being of all North Carolinians, providing human service needs for special populations including individuals who are deaf, blind, developmentally disabled, and mentally ill, and helping poor North Carolinians achieve economic independence.

Description of Work

We are seeking a highly experienced and technically proficient MES Implementation Technical Lead to join our team at Health & Human Services. This role will be instrumental in guiding the technical aspects of our Medicaid Enterprise System (MES) implementations, focusing specifically on Medicaid Claims and Encounters modules and their integration, ensuring compliance with federal and state regulations, and driving successful project outcomes.

Primary Purpose of the Position

• The primary purpose of this position is to work with the different Medicaid Enterprise System modules and Division multi-payers (NCTracks and EPS) on process improvements, implementing new requirements, and analyzing current production results. This position will serve as a liaison between the Division business owners and the vendor IT to improve productivity.
• This position must be able to analyze, forecast, and trend complex data. In addition, it will present the analysis and interpretation for operational business review. This position must support short and long term operational/strategic business activities by recommending business process solutions through research and analysis of data. This resource will be responsible for verifying, validating, overseeing, and maintaining technical application solutions for Tribal Care and Managed Care Claims and Encounter transactions in EPS and NCTracks multi-payer projects. Interaction with a broad range of clients and/or technology needed to support employees and requires strong communications skills and ability to use a wide range of technical resources for providing technical support. Position will work with internal staff, external vendors and state level services. This position will provide advanced level support for a broad range of technologies.

Job Responsibilities*** Lead the technical design, development, and implementation of Medicaid financial modules within the MES, including claims processing, encounter data, provider payments, and financial reporting.* Provide expert technical guidance and oversight to development teams, ensuring adherence to architectural standards, best practices, and security protocols.* Collaborate with business stakeholders, program managers, and vendors to translate complex business requirements into robust and scalable technical solutions.* Oversee the integration of the MES financial components with other state systems, third-party applications, and federal reporting interfaces.* Conduct technical reviews of system designs, code, and test plans to ensure quality, performance, and maintainability.* Troubleshoot and resolve complex technical issues related to Medicaid financial processes and MES functionality.* Develop and maintain comprehensive technical documentation, including architecture diagrams, design specifications, and operational procedures.* Stay abreast of federal and state Medicaid regulations, industry standards, and emerging technologies to ensure MES compliance and optimization.* Mentor and provide technical leadership to junior team members.

Knowledge Skills and Abilities/Management Preferences

Salary Grade Range: $87,617.00 - $131,426.00

Recruitment Range: $87,617.00 - $113,334.00

Candidates now meet the minimum qualifications of a position if they meet the minimum education and experience listed on the vacancy announcement.

The Knowledge, Skills, and Abilities (KSAs)/ Management Preferences are not required. Applicants who possess the following skills are preferred:

• •Progressive experience in IT, specifically focused on Medicaid Claims, Encounters, financial systems and MES implementations and understanding of Medicaid program regulations (e.g., CMS 7 Standards and Conditions,T-MSIS) and financial operations.
• •Proven experience leading technical teams in large-scale system integration and implementation projects.
• •Excellent analytical, problem-solving, and communication skills, with the ability to articulate complex technical concepts to non-technical audiences.
• •Demonstrated ability to work effectively in a fast-paced, collaborative environment and manage multiple priorities.

The Posting Will Close At 11:59 P.M. The Night Before The End Date

This Position Is Funded In Part Through Federal Funds.

This Role Requires Onsite Reporting Located Within RALEIGH, NC

About the NC DHHS Information Technology Division:

In collaboration with our partners, the North Carolina Department of Health and Human Services (DHHS) protects the health and safety of all North Carolinians and provides essential health and human services. The IT division (ITD) is one of the divisions that report to the Operational Excellence portfolio. The ITD division comprises four sections: Implementation and Operations, Strategy and Workforce, Enterprise Technology, and Vendor and Finance. ITD offers the following services but not limited to implementations, operations, project/portfolio management, infrastructure, consulting, business division liaison, digital transformation, IT

About the Office of the Secretary:

The Office of the Secretary serves as the executive leadership arm of the North Carolina Department of Health and Human Services (NCDHHS), guiding the Department’s mission to improve the health, safety, and well-being of all North Carolinians. Through strategic oversight and collaborative leadership, the Secretary’s Office supports the effective coordination of over a dozen core divisions, ensuring that agency-wide priorities are aligned, resources are used responsibly, and services are delivered with equity and impact.

Compensation and Benefits:

The State of North Carolina offers excellent comprehensive benefits. Employees can participate in health insurance options, standard and supplemental retirement plans, and the NCFlex program (numerous high-quality, low-cost benefits on a pre-tax basis). Employees also receive paid vacation, sick, and community service leave. In addition, paid parental leave is available to eligible employees. Visit the website for State Benefits .

Supplemental Contact Information

The North Carolina Department of Health and Human Services (DHHS) is an Equal Opportunity Employer that embraces an Employment First philosophy, which consists of complying with all federal laws, state laws, and Executive Orders. We are committed to reviewing requests for reasonable accommodation at any time during the hiring process or while on the job. For more information about DHHS: https://www.ncdhhs.gov/ .

DHHS uses the Merit-Based Recruitment and Selection Plan to fill positions subject to the State Human Resources Act with the most qualified individuals. Hiring salary will be based on relevant qualifications, internal equity, and budgetary considerations pertinent to the advertised position.

In accordance with the Governor’s Executive Order 303 , our agency supports second-chance employment for individuals who were previously incarcerated or justice-involved. We invite all potential applicants to apply for positions for which they may be qualified.

• Application Process
• Be sure to complete the application in its entirety. Resumes will not be accepted in lieu of completing this application.

Information should be provided in the appropriate areas, to include the following: Education, including high school and